{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T05:06:36Z","timestamp":1792213596386,"version":"4.4.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2011,11,1]],"date-time":"2011-11-01T00:00:00Z","timestamp":1320105600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2011,10,26]],"date-time":"2011-10-26T00:00:00Z","timestamp":1319587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,11]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Cost issues in liver transplantation (LT) have received increasing attention, but the cost-utility is rarely calculated. We compared costs per quality-adjusted life year (QALY) from the time of placement on the LT waiting list to 1 year after transplantation for 252 LT patients and to 5 years after transplantation for 81 patients. We performed separate calculations for chronic liver disease (CLD), acute liver failure (ALF), and different Model for End-Stage Liver Disease (MELD) scores. For the estimation of QALYs, the health-related quality of life was measured with the 15D instrument. The median costs and QALYs after LT were \u20ac141,768 and 0.895 for 1 year and \u20ac177,618 and 3.960 for 5 years, respectively. The costs of the first year were 80% of the 5-year costs. The main cost during years 2 to 5 was immunosuppression drugs (59% of the annual costs). The cost\/QALY ratio improved from \u20ac158,400\/QALY at 1 year to \u20ac44,854\/QALY at 5 years, and the ratio was more beneficial for CLD patients (\u20ac42,500\/QALY) versus ALF patients (\u20ac63,957\/QALY) and for patients with low MELD scores versus patients with high MELD scores. Although patients with CLD and MELD scores &gt; 25 demonstrated markedly higher 5-year costs (\u20ac228,434) than patients with MELD scores &lt; 15 (\u20ac169,541), the cost\/QALY difference was less pronounced (\u20ac59,894\/QALY and \u20ac41,769\/QALY, respectively). The cost\/QALY ratio for LT appears favorable, but it is dependent on the assessed time period and the severity of the liver disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.22388","type":"journal-article","created":{"date-parts":[[2011,7,18]],"date-time":"2011-07-18T18:15:43Z","timestamp":1311012943000},"page":"1333-1343","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":50,"title":["Cost of a quality-adjusted life year in liver transplantation: The influence of the indication and the model for end-stage liver disease score"],"prefix":"10.1097","volume":"17","author":[{"given":"Fredrik","family":"\u00c5berg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suvi","family":"M\u00e4klin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirjo","family":"R\u00e4s\u00e4nen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risto P.","family":"Roine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harri","family":"Sintonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Maria","family":"Koivusalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krister","family":"H\u00f6ckerstedt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Isoniemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-12-20250124","doi-asserted-by":"crossref","first-page":"11591161","DOI":"10.1002\/lt.21851","article-title":"Making dollars and sense out of liver transplantation.","volume":"15","author":"Abecassis","year":"2009","journal-title":"Liver Transpl"},{"key":"R2-12-20250124","doi-asserted-by":"crossref","first-page":"13081311","DOI":"10.1016\/j.lts.2003.09.025","article-title":"Liver transplantation is effective, but is it costeffective?","volume":"9","author":"Bambha","year":"2003","journal-title":"Liver Transpl"},{"key":"R3-12-20250124","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1177\/1077558708324299","article-title":"Cost of liver transplantation: a systematic review and metaanalysis comparing the United States with other OECD countries.","volume":"66","author":"van der Hilst","year":"2009","journal-title":"Med Care Res Rev"},{"key":"R4-12-20250124","first-page":"487488","article-title":"Economics and organ transplantation: a challenge to win.","volume":"73","author":"Biancofiore","year":"2007","journal-title":"Minerva Anestesiol"},{"key":"R5-12-20250124","first-page":"445451","article-title":"Clinical economics review: liver transplantation.","volume":"11","author":"OGrady","year":"1997","journal-title":"Aliment Pharmacol Ther"},{"key":"R6-12-20250124","doi-asserted-by":"crossref","first-page":"13811386","DOI":"10.1001\/jama.281.15.1381","article-title":"Resource utilization in liver transplantation: effects of patient characteristics and clinical practice. 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